We are recruiting for a motivated Senior Specialist, Revenue Cycle Commercial to join our team!
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Department: Billing and Collections
Job Summary
The Revenue Cycle Specialist Senior works under general supervision. This role provides financial, clerical, and administrative services to ensure efficient, timely, and accurate reimbursement of hospital and physician claims. Responsibilities include correspondence with insurance companies, patients, and other partners to resolve unpaid balances, customer service, billing, follow-up, cash application, reconciliation of payer remittances, denial management, and appeals. The role requires excellent knowledge of insurance rules, payor guidelines, regulatory requirements, claim submission, processing, and collections. Strong attention to detail and communication skills are essential. This position also serves as a resource and mentor for junior staff and supports departmental projects and initiatives.
Essential Functions
1. Maintain knowledge of revenue cycle functions and metrics. Manage accounts receivable to ensure timely payments. Initiate claims submissions, review accounts for accuracy, document contacts, identify trends, and perform root cause analysis on unpaid accounts. (50%)
2. Train staff, respond to inquiries, develop training materials, and build relationships with internal and external partners through effective communication. (20%)
3. Complete worklists and reports, analyze KPIs, identify drivers, and make data-driven recommendations to improve performance. (15%)
4. Utilize payer systems, provider portals, and internal applications. (10%)
5. Stay updated on regulatory requirements and communicate policy changes to stakeholders. (5%)
Qualifications
Education: High School Diploma or GED required
Work Experience: 4-6 years of hospital or medical office experience, focusing on claim submission, insurance follow-up, denials, and credit balances
Knowledge, Skills, and Abilities
* Intermediate knowledge of insurance billing, processing, payor rules, and regulations
* Strong communication, analytical, organizational, and problem-solving skills
* Ability to prioritize tasks independently and in a team
* Proficiency with software applications and information systems
* Knowledge of accounts receivable databases; typing speed of at least 35 WPM
* Attention to detail and professional work behavior
Additional Details
Shift: Days (United States of America)
Work Type: Regular
Salary: $23.97 - $35.96 / hr
Benefits
* Up to 27 paid days off, retirement contributions, medical plans, and more
* RTD EcoPass, on-site fitness center, childcare discounts, tuition reimbursement, career development, and other perks
Our Values
* Respect
* Belonging
* Accountability
* Transparency
All safety-sensitive positions require a pre-employment drug test. Denver Health is an integrated health care system committed to community service and diversity. We are an equal opportunity employer and value contributions from all community members. Applicants will be considered until the position is filled.
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